Treatment results and outcome in elderly patients with glioblastoma multiforme – A retrospective single institution analysis

Hoffermann, Markus; Bruckmann, Lukas; Ali, Kariem Mahdy; Asslaber, Martin; Payer, F.; Campe, Gord von

doi:10.1016/j.clineuro.2014.11.006

Cited by 36 publications

(21 citation statements)

References 89 publications

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“…These factors, along with age itself, were not associated with a decrease in overall survival. This is likely a reflection of the inherent homogeneity of a patient population that has already reached its 8 th decade of life, at which time medical comorbidities are very common and differences in age are less important than their Karnofsky Performance Scale, consistent with several studies in the elderly GBM population [ 16 , 17 ]. Also consistent with this literature, KPS was significantly correlated to overall survival [ 18 ]( Fig 2 ).…”

Section: Discussionsupporting

confidence: 68%

Factors Associated with Increased Survival after Surgical Resection of Glioblastoma in Octogenarians

et al. 2015

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Elderly patients with glioblastoma represent a clinical challenge for neurosurgeons and oncologists. The data available on outcomes of patients greater than 80 undergoing resection is limited. In this study, factors linked to increased survival in patients over the age of 80 were analyzed. A retrospective chart review of all patients over the age of 80 with a new diagnosis of glioblastoma and who underwent surgical resection with intent for maximal resection were examined. Patients who had only stereotactic biopsies were excluded. Immunohistochemical expression of oncogenic drivers (p53, EGFR, IDH-1) and a marker of cell proliferation (Ki-67 index) performed upon routine neuropathological examination were recorded. Stepwise logistic regression and Kaplan Meier survival curves were plotted to determine correlations to overall survival. Fifty-eight patients fit inclusion criteria with a mean age of 83 (range 80–93 years). The overall median survival was 4.2 months. There was a statistically significant correlation between Karnofsky Performance Status (KPS) and overall survival (P < 0.05). There was a significantly longer survival among patients undergoing either radiation alone or radiation and chemotherapy compared to those who underwent no postoperative adjuvant therapy (p < 0.05). There was also an association between overall survival and lack of p53 expression (p < 0.001) and lack of EGFR expression (p <0.05). In this very elderly population, overall survival advantage was conferred to those with higher preoperative KPS, postoperative adjuvant therapy, and lack of protein expression of EGFR and p53. These findings may be useful in clinical decision analysis for management of patients with glioblastoma who are octogenarians, and also validate the critical role of EGFR and p53 expression in oncogenesis, particularly with advancing age.

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Section: Discussionsupporting

confidence: 68%

Factors Associated with Increased Survival after Surgical Resection of Glioblastoma in Octogenarians

et al. 2015

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“…The summary results indicated a significant improvement in the survival outcomes in elderly patients who received GTR. Although most included studies reported a significant improvement in OS, four reports showed no significant therapeutic advantage of GTR vs. STR (27,36,38,40). This might be due to the small numbers of included patients, and wide 95%CIs were obtained.…”

Section: Discussionmentioning

confidence: 92%

“…A total of 76 studies were retrieved for full-text evaluation, and 57 were further excluded due to the following reasons: no appropriate control (n = 29), inclusion of younger patients (n = 20), and no sufficient data (n = 8). Therefore, 19 studies met our inclusion criteria and were selected for final meta-analysis (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). There were no additional eligible studies from the manual search of the reference lists of these studies.…”

Section: Literature Searchmentioning

confidence: 99%

Gross Total vs. Subtotal Resection on Survival Outcomes in Elderly Patients With High-Grade Glioma: A Systematic Review and Meta-Analysis

et al. 2020

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Background: The optimal strategy for the management of high-grade glioma in the elderly (≥60.0 years) remains controversial, especially regarding the effects of surgical extent on survival outcomes. The purpose of this study was to compare gross total resection (GTR) with subtotal resection (STR) for treatment effects in elderly patients with high-grade glioma.Methods: Three electronic databases were systematically searched, including PubMed, EmBase, and the Cochrane library, from inception to August 2018. Hazard ratios (HRs) or odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were used to express summary effect estimates using the random-effects model. Nineteen retrospective observational studies involving a total of 10,815 elderly patients with high-grade glioma were included in this meta-analysis.Results: The summary results indicated that GTR was associated with a significant improvement in overall survival (OS) compared with STR (HR = 0.70, 95% CI = 0.64-0.77). In addition, elderly patients administered GTR showed lower risk of 3-month mortality (OR = 0.47, 95% CI = 0.24-0.93), 6-month mortality (OR = 0.38, 95% CI = 0.26-0.56), 9-month mortality (OR = 0.35, 95% CI = 0.25-0.49), and 1-year mortality (OR = 0.40, 95% CI = 0.29-0.56). Pooled OS data differed when stratified by publication year, country, sample size, disease status, and study quality.Conclusion: GTR seems to be more effective than STR in achieving longer survival in elderly patients with high-grade glioma.

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“…Although treating elderly patients with glioblastoma has been an issue of great concern in recent years, some studies have described the use of treatments, including surgery, radiotherapy, and chemotherapy, in these patients. [11][12][13][14] Few studies, however, have explored the characteristics of these patients at the level of genetic factors, such as oncoproteins or oncogenes. These studies are generally a popular topic in research into glioblastomas because their findings usually contribute to developing more accurate therapeutic regimens and achieving better prognoses.…”

Section: Original Articlementioning

confidence: 99%

Analysis of Treatment Tolerance and Factors Associated with Overall Survival in Elderly Patients with Glioblastoma

et al. 2016

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Treatment results and outcome in elderly patients with glioblastoma multiforme – A retrospective single institution analysis

Cited by 36 publications

References 89 publications

Factors Associated with Increased Survival after Surgical Resection of Glioblastoma in Octogenarians

Factors Associated with Increased Survival after Surgical Resection of Glioblastoma in Octogenarians

Gross Total vs. Subtotal Resection on Survival Outcomes in Elderly Patients With High-Grade Glioma: A Systematic Review and Meta-Analysis

Analysis of Treatment Tolerance and Factors Associated with Overall Survival in Elderly Patients with Glioblastoma

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